HomeMy WebLinkAbout10-28-13 (2) J 150561D143
REV-15Q0 �`oZ.,,, ��;"
OFFtCIAL USE CINLY
PA DaPartme�t of Revenuz pemtsylvania cownr coaa vaer Firo N�o,��
Sureau ai individuai Taxes °@�"TM81^+�a"°^1B
ao sox.2soaol INHERITANCE TAX RETURN 21 13 p842
Harti�burg, PA 17128-0601 RESIDENT DECEDEN7
ENTER DECEDEi+Cf IttFORMATION BEIOW
Sodai Security Number C7ate af Death pate of Birth
07 21 2013 11 29 192p
6ecedenPs last Name Suffix DecedenYs First Name MI
HARTMAN EVA R.
{If ApplFeaWe)Enter Snrviving Spouse's Infortnatian Below
Spouse's Last Name Su(fix Spouse's First Name MI
Spause's SpctaE Securiky Fiumber
THIS RETURN MUST BE FILED IN DUPLICATE WITH 7HE
REGISTER OF WILLS
FtLt IN APPft4PR1ATE 4YA13 BS�OW �
_ � 1. priginaiReWm � 2. 5uppkmentalRetum � 3. RemainderRSNm(DaMOiDeaM
Priorto 12•73-82)
� 6. timkad Esrate � 4a.F�nWa Irneres�Com�romice � 5. Feeeral Estate Tax Refum RequfreQ
{CateottleeGSalier 2.12-62}
i'.=1 6 DewOmt D'istl TeeAete � � pAenc�ern�'��s tiwrp Truxt _,� 8. Totai Number ol Safe Dep45it Boxe5
I.c�J �Attw;h copy aNSiq l G
� &. LliigatiflnProceedaReceived � 16.�?9�"3'�i-�itm�ir��.r��baam � 77.E�ecfiontota%untlerSeC.9St3(AI
(Aifach Scltedide O)
. GORRESPOHDEN7-THIS SEGTON MUST BE 4pMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Neme Daydme Telephai+�Numbar„�q
r�
EARZ� RICHARD ETZWLIL�R 7�'�239 �b0� �
� R�19LE�]F V�! LS I��ILY
r" ,�._ t�r� tp 1� �
Pirst Line of Address �" �.' ;'�' � Ga `''
105 N FRON"T STREET �� `' `"' W~ �"
<a c'� -:i � � c�
�:.;t C-` t—' S""" i'T4
$ecand L€ne af Address „ 7� �Y �
"t7 Cn �
T� O
��4����� DATE FILE�
Stain ZIP Gade
�xRxsscrR� �A i�ioi
corresponag�es s�mm���adaresm: refzweiter(dtcomcastnet
R is�true��aanU�ucamplWe.�DeclRa s(I�ve ezamfned ihfe Mum,ir�udi�q at�omparryin��echaCules antl stalamenhs,and M the t�ael of my Wwwledpe antl baliet,
r8don preparar other than�ho persona�repeseMativB�is besetl on all inbrtnaUOn af which preperer hes arry knovAedge.
. SIC�tWTURE OF PERSON RESPONSIetE FOR FIUNG f2ETtIRX QATE '
�iy7�*4<j� '�"-�-' � Maxine A. Hartman 8otts /p - �g- t 3
nooaess
941{eefer Way,Mechanicshura.PA 17455
SIGNATURE OF PREPARER OlHER THAH REPRESENTATNE DATE
�� �����Gf���� Earl Richard E#zweiler /p(�-���
naor�ss
105 N. Fronf Street, Hartisburg, PA
Side 1
� 1505610143 1SQ5610b43 �
� 1505610243
REV-1500 EX
DecedenPs Social Security Number
°�^�'aN�^a: Hartrnan, Eva R.
RECAPITULATION
1. Real Estate(Schadule A)....................................................................................... 1.
2. Stocks and eonds(Schedule 6)............................................................................. 2. 6� 623 . 31
3. Closey Held Corporetion,Partnership or Sole-Proprietorship(Schedule C)......... 3.
4. Mortgages 8 Notes Receivable(Schedule D)........................................................ 4.
5. Cash,Bank Deposits 8 Miscellaneous Personal Property(Schedule E)............... 5. 42 , 837 . 42
6. Jointly Owned Property(Schedule F) ❑ SeOarate Billing Requested............ 6.
7. Inter-Vivos Transfers 8 Miscellaneous Noq Probate Property
(Schedule G) LJ Separete Billing Requested............ 7. 17 B�S B H . 2�I
8. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 22 6� 04 9 . 0 0
9. Funeral Expenses and Administretive Costs(Schedule H).................................... 9. 11 � 995 . 04
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................ 10. 16� 442 . 41
11. 7otal Deduetio�n(toWl Lines 9 and 10)................................................................ 1 t. 2 B � 437 . 45
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 197� 611 . 55
13. Charitable and Govemmeotal BequestslSec 9113 7rusts for which
an eiaction to taz has not been matle(Schedule J)............................................... 13.
14. Net Value Subjeet to 7ax(Line 12 minus Line 13)............................................... �q, 197 , 611 . 55
TAX COMPl1TATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 74 taxable
at tha spousal tax rate,or
transfers under Sec.9116
(a)(t z)X.00 i 5. 0 . 0 0
16. Amount of Line 14 taxable 197 611 . 55 16. 8
at lineal rete X .045 � r 8 92 •52
17. Amount of Line 14 taxable
at sibling rate X.12 - 0 . 00 17. � 0 . 00
18. Amount of Line 14 taxable
at collateral rate X.15 0 . 00 18. 0 . 00
19. TAX DUE................................................................................................................ 19. 8 � 892 . $2
20. FIL�IN THE OVAL IF YOU ARE REQUESTING A REPUND OF AN OVERPAYMENT. �
Side 2
� 1505610243 1505610243 J
REV•7500 EX Page 3 File Number 21-'13-0842
DecetfenYs Camplete Address:
DEGEDENTS NAME
Hartman, Eva Ft.
STREETADORESS
100 Mt Alien Drive
CIFY STATE ZIP
Mechanicsburg PA 17085
Tax Payment8 and Credits:
1. Tax Due(Page 2,Line 79) (1) 8,892.52
2 CreditstPayrr�rds
A. Prior Payments
B. Discount 0.00
Totai Credits{A �B} (2? 4.00
3. Interest (3)
4, If Lina 2 is greater thsn Line 1 +Line 3,enter the d'dference, This is the OVERPAYMENT. (4}
Check box on Page 2,Line 20 W request a rafund �' "`—
�, if L.ine t +�.i�3 is greatm than Line 2,erder the difte�ence. This is ttre TAX DU£. (6} $a$g,�',rj2
Malce Check Pa able ta: REt31STER t}F W�l.1.S AG�MT.
PLEA$E ANSWER THE FOLLOWING QUEBTIONS 6Y PIACING AN "'X" IN THE APPROPRIATE BLOCKS
t. Did tlecedont make a trsnsfer and: Yes No
a. retain the uu ar income of tha Properly trensferrdd:............................................................................... x
� b. retain the right tp designate who shall use the property Vansferred or iSS income;.._...............__........... x
c. retain a reversiona+y interosk or.._..................._.........._.._....................................._.._......._....._....._...... x
d. receive the promise tor life af eRher payments,benefits or care?............................................................
2. If death occurred aRer Dec. 12, 1982, did decedent transfar property within one year of death wkhout
raceivingadeQuateconsideration7..........._......................................................................._................._........._ ❑ �
3. 6id deudent ovm sn 9n trust fot a payebie upon tlesth bank accaunt or security et his or her death?....... ❑ �
4. Did decndbnt own an individual retirement at�ount,annuity,or other non-probate property which
contains a beneficiary designation?.................................................................................................................. ❑x ❑
( IF THE AFt5WER i0 ANY QF THE AHOVE QUES'f WN$IS YES,Y6U bHlST COMPLETE SCHEDUIE G AttD FIIE i7 AS PAI2T 6F THE ftE1'URN.
� �
. For dates o/deeth on or after July 1, 1984 aM betore Jan. 1, 1995,the tax rate imposed on the net value of trensfers to or tor the use of the survNing
spouse is 3 percant[72 P.3.§9116{a){1.1}(i}�.
For dates of Geath on or after January!,1995,the tau rote impo6ed on the rret vsiue of#ransfers to or#or the�se of the survrving spouse is 0 percent
p2 P,S.§9716(a)(1.1)(ii)�. 'fhe sGtute does not exompt a trensfer to a surviving spouse fmm ta�c,and the statutory requirements for disGosure af
asseta and filing a tax ietum are still applicable even K the surviving spousa is tbe only baneficiary.
For d�tas of death on or after Juty t,2000:
. 7Te tax wte impoxtl on the net vaiuo oF 2rensfars from a deceased chiVd 21 years oi age or younger at death to or for i�e use af a natural parent,an
adaptive parent,or a stepparent M tM1e child is 0 pereent p2 P.S.§9116(a)(1.2)].
. The tax rate imposed on the net value of transfers to or for tha use of the decedenYa Uneal beneficiaries is 4.5 percent,except as noted in
j72 P.S.§9116{a}{t)j.
, The tarz rate imposed on tM1e net value of hansfer6 to or for the use of the decedenPs sibiings is�2 percent(72 A.S.§9196(a}(t.3}j. A
sibling is deflned under Section 91p2,as an indivitlual who has at least ane parent in common with the decedent,whethsr by blood or adoption.
Rer-t6o3 EX+j63tl)
� scMEC►u�� s
STOCKS � BONDS
coi.wwc�wewin�orpL�HHSnvnNu
Ilk1ERRNJCE TPX ICEiURN
RESioEM pECEtlE�
ESTATE OF FILE NUMBER
Hartman, Eva R. 21-13-0842
AII P�oPa�h'IaMiY-cwnMvhHr ripM W�urv�vurahtP nwst hstlieUwW on SchaauN F.
ITEM CUSIP VALUEATDATE
NUMBER NUMBEFt DESCRIPTIQN UNIT VALUE OF DEATH
1 A!e#Iife Stock-33 shar��$49.07 per share 1,619.31
2 Series EE Savings Bond#p19524160EE issued January 834.00
1989 face vaiue of S5Q4.00
3 Series EE Savings Bond#D79524162EE issued January 834.00
7989 tace value of;504.00
4 Series EE Savings Bond#D19524163EE issued January 834.00
1989 face value of 5500.00
5 Series EE Savings Bond#D19324164EE issuad January 83d.00
1989 face value of 5500.00
6 Series EE Savings 8o�d#D1952d165EE issued Jaauary 83+t.00
7989 faae value af 5500.Op
7 Se�ies EE Savings Bond#D78b24166EE issued January $34.�
1989 face value of 5580.00
TOTAI.(Also enter on Llne 2.RecaRitulation) 6.623.31
(it rtrore space is neetleif,sdGiaonai paAes oi the same size}
Copyright(c)20p2 fortn sofiware only The Lackner Group,Ina Form pA-1600 Scbedule B(Rev,6-98)
—_ � II
Rw-0606 EX+{tY-10)
SCHEDULE E
pennsylvania CASFf, BANK DEPOStTS, � MISC.
6EPARTMEN7OF REYEPHtE
INHERITANCEiPJ(RETURN PERSONAL PROPERTY
RESIDEN7 pECE�ENT
E5TATE OF FILE NUNIBER
Hartman, Eva R. 21-13-�42
r�eU» dr .nax,emnubaoc�l.,�rerec«veaafu,.mate.
w
Ae WoPMY cwnM tlw ei�d�rrtvivonMP must ba @�eio�sEan�ehKMBa F.
i'I"EM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Cltizeris Bank ctrecking accourrt#64�1784290 2.3$8.83
2 Citizens 9ank checking account#6234445679 1,427.41
3 Cikizer�s Bank money marlcet savings accourrt#6236792066 27,340.55
4 Sovereign 8ank certlflcate of deposit account#1055352856 10.40p.64
5 Savereign Bank chacking aecount#r035A002297 1,684.03
1
TOTA�{Also enter on Line 5.RecapftulaBOn) 42,$37.42 '
� {H more spmcx is neeaea,aaditbnel pspea ot me same size} �
Copyright(c)2010 fortn software only The Wdcnar Group, Ine. Fortn PA-16D0 Sehedule E(Rev. 11-10)
L
Rev.iNO EX�(OB-09)
SCHEDULE G
pennsylvania lNTER-VIVOS TRANSFERS AND
DEPARTMENT OF REVENUE
INHERITANCETAXREfURN MISC. NON-PROBATE PROPERTY
RESIOENT DECEDENT
ESTATE OF FILE NUMBER
Hartman, Eva R. 21-13-0842
This schatlule muat be mmpklaE antl filetl d the enswer lo eny N puastions 1 NrouBh 4 on pape t�ree W IM REV-1500 is yes.
Il'EM DESCRIPTION OF PROPERTY DATE OF DEATH %OF DECD'S ExcwswN TAXABLE
NUMBER 7�7N{E DATE O�F TR�MFISFRER.SATTACNTA COPVEOFTTME DEED�OR REAL ESTAN E. VALUE OF ASSET �NTEREST (IF APPLICABIE) VALUE
1 American General Life Companies Annuity Contract 114.690.79 714,690.79
#VP220993
2 Principal Financial Group Annuity Contrect#863556 61,697.46 61.697.48
TOTAL(Aiso enter on Line 7, Recapituiation) 176,588.27
Qf more space is neetled,adOitlonal pages ot the same size)
Copyright(c)2009 form soflware only The Lackner Group, Inc. Fortn PA•1500 Schedule G(Rev.OB-09)
REV4511 EXi(70-0Y)
pennsylvania SCNEDULE H
DEPAR7MENTOFREVENUE FUNERAL EXPENSES AND
INHERITANCETAXRETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Hartman, Eva R. 21-13-0842
DecedenPs debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
p. FUNERAL EXPENSES:
See continuation schedule(s)attached 7,417.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zio
Year(s)Commission Paid
2. Attornev's Fees EeN RiChafd EtiWeil@r 4,000.00
3. Family 6cemption: (If decedeM's address is not the seme as GaimanPs,attach explanation)
Claimant
Street Address
City State ZiD
Relationshio of Claimant to Decedent
4. Probate Fees 263.50
5. AccountanPs Fees
6. Tax Ratum Preparer's Fees
7. Other Administrative Costs 7 25.00
See continuation schedule(a) attached
TOTAL(Also enter on line 8, Recapitulation) 17,805.50
Copyright(c)2009 form sottware ony The Lackner Group,Inc. Form PA-1500 Schedule H(Rev. 10-09)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Hartman, Eva R. 21-13-0842
ITEM
NUMBER DESCRIPTION AMOUNT
Funerel Exoenses
7 Hoover-Boyer Funeral Homes, Inc.,funeral bill 7,q�7,pp
H-A 7,417.00
Other Administntive Costs
2 Cumberland County Law Joumal,advertise Letters 75.00
3 Earl Richard E�weiler-Photocopies,postage, notary fees etc. 50.00
4 The Sentlnel,advertlse Letters �gg,yq
H-67 314.54
Copyright(c)2002 form soHware only The Lackner Group, Inc. Fortn PA-7500 Schedule H(Rev.6-98)
Rev4512 EXr�1P-08)
SCHEDULE 1
pennsylvania DEBTS OF DECEDENT,
DEPARTMENTOFREVENUE
INMERITANCETA%RETURN MORTGAGE LIABILITIES AND LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUNIBER
Hartman, Eva R. 21-13-0842
Raporl tlsbb Ineumtl Dy tlro Ge�dont priw ro MNh M�t�InM unpW ettha tlale M tlaaM.IneluGnp unMmbunstl nwdleN�xp�mn.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Aiert Phartnacy Services, Inc.,medicine 103.11
2 Messiah�Ilage, final nursing home bill 16,324.30
3 Paul D. Dalbey,DPM, medical bill 15.00
TOTAL(Also enter on Line 10, Recapitulation) 16,442.41
Qf rtrore space is neetletl,atlAitlonal pages of Ne same size)
Copyright(c)2008 fortn software only The Lackner Group, Inc. Form PA-1500 Schedule I(Rev. 12-08)
REV-0577 EXi(Ot-00) ,
pennsylvania SCNEDULE J
DEPAR7MENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RES�DENT DECEDENT
ESTATE OF FILE NUMBER
Hartman, Eva R. 21-13-0842
REIATIONSHIP TO
NAME AND ADDRESS OF SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER pERSON(Sl RECEIVING PROPERTY DECEDENT (yyords) ($$$)
I TAXABLE DISTRIBUTIONS [indude outright spousal
distributions,and trensfers
under Sec.9116 a 12
Michelle Louise Botts Bames Grenddaughter 76.67% Residue 32,695.56
210 Linda Drive
Mechanicsburg, PA 77055
Susan Annette Botts Fake Granddaughter 16.66% Residue 32,875.83
32�Ilow Way Drive
Enola, PA 77025
Jill Elizabefh Botls Hammaker Granddaughter 16.67% Residue 32,895.56
4073 Regiment Blvd.
Enola, PA 17025
Maxine A. Hartrnan Botts Daughter 50% Residue 98,666.95
10 Kcefer Way
Mechanicsburg, PA 17055
Total 197,333.90
Enter dollar amouMS for disfrWutlons shown above on lines 15 throu h 18 on Rev 1500 cover sheet as a ro riate.
NON-TAXABLE DISTRIBUTIONS:
II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SI1EE
Copyright(c)2010 fortn soflware onty The Laekner Group,Inc. Fortn PA-1500 Sehedule J(Rev.Ot-10)
� '
COPY FAIR = o
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LAST WILL AND TESTAMENT O� T= r � �
v �A '
� �`
.�..� �.... �..
'.1 �.� t . .. ., �
EVA R. HARTMAN ,.; �- ' ...
� U ' �--.. �- ;
I, EVA R. HARTMAN, a resident of East Pennsboro '1"ownship, Cifmberland
County,Penns,ylvania,being of sound and disposing mind,memory and understanding,do hereby
make,publish and declare this instrument to be my Last Will and Testament,hereby revoldng any
and all wills by me at any time heretofore made.
I'I'EM I: I direct my hereinafter named Executor to pay all my just debts, funeral
expenses,administrarion expenses and inheritance, estate, succession or excise taxes,which I owe
or may become due on account of my death, as soon as may be convenient after my decease.
ITEM II: All the rest, residue and remainder of my estate,be it real, personal or
mixed, of whatever nature and wheresoever situate which I may own or have the right to dispose
of at the time of my decease,I give, devise and bequeath to my husband, Thomas 7. Hartman, of
97 Hillside Circle, Camp Hill, Pennsylvania 17011, provided he survives by sixty (60) days.
ITEM III: If my said husband should fail to survive me by sixty (60) days, then
I give, devise and bequeath a life estate in the property l�own as 97 Hillside Circle, Camp Hill,
Pennsylvania, to my daughter, Maxine A. Hartman Botts, of 6 Bili Dugan Drive, Etters, York
County,Pennsylvania,provided she continues to reside in the premises,without liability for waste
for the remainder of her natural life or so long as she desires to retain her life estate in the same,
with my said daughter to pay all costs of maintenance, including taxes, assessments, ordinary
repairs, and insurance with the insurance to be in such reasonable amount insuring the interest of
(SEAL)
Eva R. Hartman
_ _
the remaindermen.
A. The life tenant shall be excused from filing any type of bond for the
protection of the remaindermen.
B. Should Maxine, my daughter, not choose life estate at the premises of
97 Hillside Circle, Camp Hill, Pennsylvania,then,my complete estate shall be divided as follows:
After all debts resulting from my death are paid, I would like $1,000.00 to be given to the
Evangelical Congregation Church,Center Street,Wiconisco,Pennsylvania. The remainder of my
estate shall be divided by one-half of the estate to be given to my daughter, Maxine. The
remainder of the estate shali be divided equally to my three granddaughters with this advice: "for
your personal use for you and child and/or children of your blood", i.e. (7ill and Matthew; Susan
and Katie, Benjamin, Corey and Sazah; and Michele, you may need it someday).
C. If any one of my granddaughters would not wish to retain the property
in kind, then said property shall be sold by my hereinafter named Executrix or Executor and the
net proceeds divided equally among my three granddaughters.
D. If my said daughter should vacate said premises, then I direct my
hereinafter named Executrix or Executor to sell said premises and the net proceeds to be divided
equally among my daughter and three granddaughters, as follows:
1. Maxine A. Hartman Botts, of 6 Bill Dougan Drive,
Etters, Pennsylvania
2. Michele Louise Botts Bames, of 210 Linda Drive,
Mechanicsburg, Pennsylvania 17055
3. Susan Annette Botts Fake, of 2195 Vailey Street,
(SEAL)
Eva R. Harlman
. __ _
Enola, Pennsylvania
4. Jill Elizabeth Botts Hammaker, of 217 Shaffer Street,
Enola, Pennsylvania.
ITEM IV: If my said husband should fail to survive me by sixty(60) days, then
all the rest, residue and remainder of my estate, be it real, personal or mixed, of whatever nature
and wheresoever situate which I may own or have the right to dispose of at the time of my
decease, I give,devise and bequeath to be equally divided among my following daughter and three
granddaughters:
1. Maxine A. Hartman Botts, of 6 Bill Dougan Drive,
Etters, Pennsylvania
2. Michele Louise Botts Barnes, of 210 Linda Drive,
Mechanicsburg, Pennsylvania 17055
3. S�san Annette Botts Fake, of 2195 Valley Street,
Enola, Pennsylvania
4. 7i11 Elizabeth Botts Hammaker, of 217 Shaffer Street,
Enola, Pennsylvania.
A. If any of my said beneficiaries liste3 in Items III and IV above shall
predecease me or die simultaneously with me leaving issue to survive, then such share shall pass
to the issue of such beneficiary, per stirpes.
B. If any of my said beneficiaries listed in Items III and IV above should
predecease me or die simultaneously with me without leaving issue to survive, then such share
shall be divided among the remaining beneficiaries or their issue per stirpes.
(SEAL)
Eva R. Harlman
ITEM IV: No interest in income or principal shall be assignable by or available
to anyone having a claim against a beneficiary before actual payment to the beneficiary.
ITEM V: I hereby nominate, constitute and appoint my husband, Thomas 7.
Hartman, Executor of this my Last Will and Testament, with full power in his discretion to do
any and all things necessary for the complete administration of my estate, without being required
to file bond for the performance of his duties, with full power to sell at public or private sale and
without order of court any real or personal properiy belonging to my estate, and to compound,
compromise or otherwise settle or adjust any and all claims, charges, debts and demands
whatsoever against or in favor of my estate as fully as I could if living.
A. If my said husband should predecease me, die simultaneously with me or be
unable or unavailable to serve or complete his duties, then I nominate, constitute and appoint my
daughter, Maxine A. Hartman Botts, Executrix, with the same power and authority as given my
said husband.
B. If my said daughter should predecease me, die simultaneously with me or be
unable or unavailable to serve or complete her duties,then I nominate, consritute and appoint my
three granddaughters, Michele Louise Botts Barnes, Susan Annette Botts Fake and Jill Elizabeth
Botts Hammaker, CoExecutrices, with the same power and authority as given my said husband.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my I,ast
Will and Testament this 9th day of November, 1996.
(SEAL)
Eva R. Haztman
_ _
Signed, sealed, published and
declared by ihe above-named
Eva R. Hartman as and for
her Last Will and Testament, in
the presence of us, who at her
request, in her presence and
in the presence of each other,
we believing her to be of
sound and disposing mind,
memory and understanding,
have hereunto subscribed our
names as witnesses this 91h
day of November, 1996.
�_��r'-'�==' ��3't�i�'ILL AND TESTAMENT CJ►F
p��»IJ'c.�� iJ; .';;�_�S
:'��i3 �;4G 2 F� 1 ui��'A R. HARTMAN
3���t� �� HARTMAN, a residern of East Pennsbora Tuwnship, Cumberland
a���,.z��� cc��y�r
County, �����e�o��ound and disposing mind, memary and understanding, do hereby
make, publish and declare this insGument to be my I.ast Will and Testament, hereby revoking any and
atl wills by me at any time heretafore made.
I'TEM I: I direct my hereinafier named E�cecutor ta pay atl my just debts, funersl
e�cpenses, administratian expenses and inheritance, estate, succession or eaccise ta�ces, which I owe
or rnay becarne flue on account of my daa#h„ as saan as may be convenient after my decease.
ITEM IIr All the rest, residue aad remaindu of rny estate, be it real, personal ar
mixed, of whatever nature and wheresoever situate which I may awn or have the right to dispose of
a# the time af my decease, I give, devise and t�eqaeath to my husband, Thomas 7. Iiertman, of 97
I�llside Circle„ Camp Hill, Pennsytvania 17421,provided he survives by sixty{b4}days.
ITEM III: 1f my said husband should fail to survive me by sixty(60) daqs, then I
give, devise and bequeath a life estate in tha properry known as 97 Flillside Circle, Camp I�itl,
Pennsyivania, ta my daughter, MaJCine A FIartman Batis, of 5 Bili Dugan I3rive, Etters, Yark
County,Pennsylvania„provided she continues to reside in the prernises, without liability for waste for
the remainder af her nahu�al life ar so long as she desires ta retain her life estate in the same, with my
saifl davghter ta pay a21 costs of maiatenance, inoluding ta7ces, assessments, ardinary repairs, and
insurance with the insurance to be in such reasonabie amount insuring the interest nf the
remaindermen.
A. The fife tenant shall be eaccused fram filiag any typa af bond for the
protection ofthe remaindermen.
�;ityi .r'�/�c '?".���G�._.z.,�.�-_... (SEAL)
Eva R. Harkman
��
B. Should Maxine,my daughter, not choose life estate at the prbmises of 97 Hipside Circle, Camp Hill,
Pennsylvania;then, my complete estate shall be divided as follows: After all debts resulting from my
death are paid,I would like$1,000.00 to be given to the Evangelical Congregational Church, Center
Street,Wiconisco,Pennsylvania. The remainder of my estate shall be divided by one half of the
estate to be given to my dauQhter Maxine. The remainder of the estate shall be divided aquy(ly to
-- —�_
my tivee granddaughters witli this advice: "for your personal use for you and child and/or children
of your blood.", i.e.,(Jill and Matthew; Susan and Katie,Benjamin, Corey and Sacah;and Michele,you
ma,y need it someday).
`-'�'' ' �,/ �i+�-F„'�.'
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_ _ _
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._._ �--."'-.- - - ----• • -- -
pnnc�pa�l;however,ti-ie li�a f�en�tt"stiall tiave full disci�etion�m c7eternumng whether an item-is-pr-ineapal-,
or'income;-and.auch decision shaltbz-fimding pon e remam ermen:
C. ZIpea-�e-d , _ 'ately
terminate;.and I-give, devise-a�d-beqneaththe-re�einder-irrterSSt i`n e ivided
�Y u��'�' .
1. Ivfichele Louise Botts Bames, of 210 Linda Drive,
Mecnar.icsbura, Pennsylvania 17055
2. Susan Annette Botts Fake, of 2195 Valley Street,
I
Enola, Pennsylvania
� 3. Jill Elizabeth Botts Hartunaker, of 217 Shaffer Strat,
• Enola, Pennsylvania.
D. If any one o£my ganddaughters would not wish to retain the property in
'` kind, then said property shall be sold by my hereinafter named Executrix or Executor and the net
proceeds divided equally among my three granddaughters.
E. If my said daughter should vacate said premises, then I direct my
hereinafter named Executrix or Executor to sell said premises and the net proceeds to be divided
equally among my daughter and three granddaughters, as follows:
1. Maxine A. Hartman Botts, of 6 Bil!Dougan Drive,
Etters,Pennsylvania
2. Michele Louise Botts Bames, of 210 Linda Drive,
Mechanicsburg, Pennsylvania 17055
ln.mi�l'tfv���,�,-w,.�� (SEAL)
Eva R. Hartman
;
._.__._ . ______.__ _�_----- �. _.._._._�..,...�.__ _
S. Should Maxine,my daughur, not choose life estate at the premises of 97 Hillside Circle,Camp Hill,
Pennsylvania;then, my complete estate shall be divided as follows: After all debts rewlling from my
death are paid, I would like S1,�0.00 to be given to the Evangelical Congregational Church,Center
Strcet, Wiconisco,Pennsylvania. The remainder of my estate shall be divided by one half of the
estate to be given to my dau¢hter,Maxine. The remainder of the estate shall be diivided_equ�ally to
my three granddaughters with this advice: "for your personal use for you and child and/or cLildren
of your blood.",i.e., (Jill and Matthew; Susan and Katie,Benjamiq Corey and Sarah;and Michele,you
may nced i[someday).
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3. Jill Elizabeth Botts Hammaker, of 217 Shaffer Street,
Enola, Pennsylvania.
D. If any one of my ganddaughters would not wish to retain the property in
kind, then said property shall be sold by my hereinafter named Executrix or Executor and the net
proceeds divided equally among my three granddaughters.
E. If my said daughter should vacate said premises, then I direct my
hereinafter named Executrix or Executor to sell said premises and the net proceeds to be divided
equally among my daughter and ttuee ganddaughters, as follows:
1. Maxine A Hartman Botts, of 6 Bill Dougan Drive,
Etters, Pennsylvania
2. lvfichele Louise Botts Barnes, of 210 Linda Drive,
Mechanicsburg, Pennsylvania 1'7055
(�+,�����t��.y.- (SEAL)
Eva R. Hartman
3. Susan Annette Botts Fake, of 2195 Valley Street,
Enola, Pennsylvania
4. Jill Elizabeth Botts Hammaker, of 217 Shaffer Street,
Enola, Pennsyivania
1TEM IV: If my said husband should fail to survive me by sixty(60) days, then all
the rest, residue and remainder of my estate, be it real, personal or mixed, of whatever nature and
wheresoever situate which I may own or have the right to dispose of at the time of my decease, I
give, devise and bequeath to be en,ua!ly divided atnong my following daughter and three
granddaughters:
1. Maxine A Hartman Botts, of 6 Bill Dougan Drive,
Etters, Pennsylvania
2. lvfichele Louise Botts Barnes, of 210 Linda Drive,
Mechanicsburg,Pennsylvania 17055
3. Susan Annette Botts Fake, of 2195 Valley Street,
Enola, Pennsylvania
4. Till Elizabeth Botts Hammaker, of 217 Shaffer Street,
Enola, Pennsylvania.
A. If any of my said beneSciaries listed in Items III and IV above shall
predecease me or die simuttaneously with me leaving issue to survive, then such share shall pass to
the issue of such beneficiary, per s6rpes.
B. If any of my said beneficiaries listed in Items III and IV above should
predecease me or die simultaneously with me without leaving issue to survive, then such share shall
be divided among the remaining beneficiaries or their issue per stirpes.
�it'�i.Pe.4la.��,-+�—�-� (SEAL)
Eva R Hartman
_ _
TTEM IV: No interest in income or principal shall be assignable by or availabie to
anyone hav'sng s claim against a beaeficiary before actuat gaymem ta the beneficiary.
ITEM V: T heseby naminate, constitute and appoint my husband, Tharnas 7.
Hartman, Executor af this my Last Wilt and Testament, with fiil] power ur his discre6on ta do any
and all thiags necessary for the camplete administration of my e.�tate,withaut being required to file
bond for the performance of his duties, with full power to sell at public or private sale and vvithout
order of court any m,a2 or persanal property belonging to my estate, and to compound, compromise
or otherwise settte or adjust any and all claims, charges,debts an�demands whatsoever aga'snst or
in favor of my estate as fully as I could if living.
A. If my said husband should predecease me, die simultaneously with me or be
unable or unavaitable to serve or comp2ete his duties, then I naminate, constitute and appoint my
daughter,Maxine A Fiartman Botts,Fa�ecutrix,with the same power and authority as given my sa'rd
husband.
B. If my said daughter shavld predecease me, die simultan�us�y with me ar be
unablt or unavaitabte ta serve or complete her duties,then I nominate, constitute and appoint my
three granddaughters, ivTichele Louise Botts Barnes, Susan Annette Botts Fake and J'ill Elizabeth
Botts FIammaker, CoExecutrices,with the same power and authority as given my said hnsband.
IN WITNESS WHEI2EQF, I have hereunto set rny hand and sea! ta this my Last
Will and 1'estament this 9th day ofNovember, 1996.
c;.�..,�- /�',•`��f.k.c.---' (SEAI,)
Eva R Hsrtman
Signed, sealed, published and
declared by the above-named
Eva R Hartman as and for
her Last Will and Testament, in
the presence of us, who at her
request, in her presence and
in the presence of each other,
we believing her to be of
sound and disposing mind,
memory and understanding,
have hereunto subscribed our
names as witnesses this 9th
day of November, 1996.
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Calculated Value of Your Paper Savings Bond(s) Page 1 of 1
Calculated Value of Your Paper Savings Bond(s)
Caiculator Results for Redemption Date 07/2013
Total Price Totai Value Total Interest YTD Interest
1 500.00 5 004.00 3 504.00 194.40
Bonds: 1-6 of 6
Issue Ne�ct Final Issue Interest
Serial # Series Denom Date Accrual Maturity Price Interest Rate Value Note
D19524166EE{ EE__ �SOOr01/1989�01/2014� O1f2019r___�250_OOr �584_00+ 4_00%� $834.00, ___
D19524165EE EE �SOO�Olf1969 O1/2014 ,01/2019r �250.00r $58400� 4_00%� ;63400�
. -
D19524162EE .EE ' �500 Ol/1989rO1f2014 O1f2019r _,�250.00r_..�58400� 4:00%� __$83400r _ _
D19524160EE EE _�,__�500 OL/1989rO1f2014 Ol/2019r _�250.00r ._�56400r 4.00%� __$83400r
D19524163EE� _EE__,__�SOOr01%1989r01/2014 Ol%2019r _�250.00r _�58400r 4.00%T_$83400r _
D19524164EE_ EE _ �500 O1f1.969 O1f2014 O1/2019r �250.00r �584:OOr 4.00%y #83400� ___.
Totals for 6 Bonds; 1 500.00; 3 504.00; ; 5 004.00;
Notes
NI ;Not Issued
NE ?Not eligible_for payment__________________
P5 'Includes 3 month interest_penalty_.____.___
- - ---- ------- - -
MA 'Matured and not earnin interest
http://www.treasurydirect.govBGSBCPrice 8/14/2013
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ETZWEILER AND ASSOCIATES
ATTORNEYS AT LAW
105 NORTH FRONT STREET
HARRISBURG PA 17101-1436
Estate of EVA R HARTMAN
Date of Ikath: Ju121, 2013
SSN: 178-16-6260
Dear Su/Madam:
In accordance with your request,ihe attached informadon sheets ha�e been provided in the above
decedenEs name as of his/her date of death. As per your raquest no jomt owner's on �y accounts were
found.
For all other inquiries,please call 877-579-2667
Sin elyr� �✓�""'—`7
rlanda Brasil
Decedent Account Processing
REF#: 609690
�;� �itiz+�ns �ank��
Account Number 6100784290
Account Trtle EVA R HARTMAN
Date ened 10/27/1976
Account T e Checkin
Princi a1 Balance as of DOD $2380.83
Interest from Last Postin to DOD $ .00
Account Balance as of DOD $2380.83
YTD Interest to DOD $ .00
�,� Citi�er�s �ar�� �
Account Number 6234445679
Account Title MAXINE A BOTTS /REP PAYEE FOR EVA R
HARTNIAN
Date ened 11/29/2012
Account T e Checkin
Principal Balance as of DOD $1421.41
Interest from Last Postin to DOD $ .00
Account Balance as of DOD $1421.41
YTD Interest to DOD $ .00
�� C�tiz�ns Bart�C°�
Account Number 6236792066
Account Title EVA R HAR'IMAN
Date O ened 1/4/2013
Account T e Checkin
Princ' al Balance as of DOD $27330.30
Interest&om Last Posting to DOD $10.25
Account Balance as of DOD $27340.55
YTD Interest to DOD $195.80
� ,
Sovereigri � �
� Court Ordered Processing\Decedents- MAl-MB3-02-10 - P.O.Box 841005 - Boston,MA 02284
�
�
�
3 September 23, 2013
�
9
� Earl Richard Etzweiler
� Etzweiler and Associates
� 105 North Front Street
a Harrisburg, PA 17101-1436
�
�� RE: Estate of Eva R. Hartman
Date of Death: 07/21/2013
�
�
� Dear Earl Richard Etzweiler:
�
� Per your request, enclosed please find the account information as of the date of death
� for the above-named decedent. For your information, accrued interest is not included in
the date of death balance.
� Please feel free to contact me if I can be of any further assistance.
f
� Very truly yours,
� �
� Ashley Nob
� [COP Specia �st III]
� 617-514-5189
s
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Sovereign Bank
ESTATE OF Eva R. Hartman
SOCIAL SECURITY#: 178-16-6260
DATE OF DEATH: July 21, 2013
Account#: 0354002297 Type: Checking Open date: 1/1/1971
In the nsme of: Eva R. Harfman
Date of Death Balance: $1,693.99
Int.(YTD) from 1/i/2013 to 7/21/2013 ��•�
Accrued interest to date of death: $0.00
Otherinfo:
Account#: 1055352858 Type: CD Open date: 4/13/2002
In the name of: Eva R. Hartman
Date of Death Balance: $10,000.00
Int.(YTD) from 1/1/2013 to '1/21/2013 $13.43
Accrued interest to date of death: $0.60
Otherinfo:
Page 1 of 1
American General
Life Companies
September 27, 2013
EARL RICHARD ETZWEILER
105 N FRONT ST
HARRISBURG PA 17101-1436
Re: Annuity Contract VP220993
Contract Owner Eva R Hartman, Deceased
Dear Mr. Etzweiler:
Thank you for yot�r correspondence dated September 19, 2013 regarding this annuity held with
Western National Life Insurance Company. Listed below is the relevant death benefit information
for the above-referenced annuity contract.
Contract Numlier = ;, 'z'% ,�� �5,� .�n'.,";`� ,� �;"� , i,i:
T e of Annuit Contract: Flexible Premium Non- ualified Tax Deferred Annuit
Date of Issue: December 1, 2005
Contract Owner's Name s : Eva R Hartman
Cost Basis $88,000.00
Accumulated Value as of $114,890.79
Date of Death on 7/21/2013:
Total Death Benefit as of $115,525.22
toda 9/27/2013:
Named Benefici ies : Maxine Botts, dau hter
Mr. Etzweiler, we appreciate the opportunity to assist you. Should you have any questions,
please contact our Client Caze Center at 1-800-424-4990.
Sincerely,
�1��� �
Billie Vanderfor�
Annuity Claims Department
American Generel Life Insurance Company
P.O. Box 871 •Amarillo,TX•79105-0871
LH-AGL
Oct, 4. 2013 5:OBPM ETZWEILER&ASSOCIRTES 1172345610 No. 1594 P• 1 1
�'�ZWEII.ER AND ASSOCYATES
ATTORNEYS-AT-LAW
105 NO1tTH FRONT STREET
FIARRiSBURG,P,r� 17101-1436
O,pin horn�Mow Fr16r00 aw.-J:00 p�n.
(7t�z3aseoo
Pc�Rfafiud F.�WB�lr�F�qmtt _ "—"
Wvirtim S.DaYh'v,P.cquiro HAIJPAX T.[NE
(71'�8%•3737
225 Mckat Sheot Fax Lina(71�234-5610 2 Wat hf�m 8trat
MiUa�b�.PA I7061 &u�0 Addra�i wtswNler�mmwl.eM Plix�t1tv111e,PA 17023
(71'�692•2519 (71'n 362�8395
O,Qkr horrot 7Lee.a+�f AYL Ir40P+h,d:00 R� OJ�es howr:Tl�wx 7:00 p�..f.�l1 p�.
S�R 19.00 aw.-17:90 noa�
October 4,2013
FA7C T0: 1-866-894-2087
Principal Life Insurance Compauy
Attn; RIS Annuity Strvices T-10-W40
711 High stzeet
Des Moines,IA 50392-1770 �
RE: Eva R. Fiarttnan Estate
D.O.D. 7/21/13
Contract No. 8635556
Thia office represents the Estste of Eva R�iactnrwA whp died on Suly 21,2013,a iacident
ofi7pper Alien Townalrip.Gl�mbede�County,Pewsylvenie,ead wtwee Social SeanityNumbaris 178-16-
6260. I have attached a capy of the death certiflcatq short certiScau end signed authoriution.
Would you pleese complete the bottom portion of this lettw for�Il accoante in�Lic6 the
decedent had an iaterest in u of the date of dnth�6mring the bslanu in aid sceon�(�)at date of
dwth and have tho aauu ei�aed by the app=opziate offrcer or m�ployee of your flneneial lnstitutioa
SincerelY Yo�>
ERE:db ParlRichard�ler
A�o,�t x,��g> �63 3J'6
Type of a«ount
Dste Opaned S a 9-ol o0R
Acernad Intrat pabd calandu
yerr up to d�to of de�th � . y
Principel Halance
ae of Ax.aimt'e Death �6� 97.`f
Ancsued Iuuterest
mot diabuzaed ae of
M1ylfl�lLOI1MdlM1 W rirYYraw�
II��11 I
II�Sa/�Mw1iMSU�w IWVY�n/UYSUw�
14'Or{,I'�170f1 0lMMb M IlW
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tiwa�..M�.nCae�WY+s.M+cww� "
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HOOV ER-BC1YEFt
!='UlVBRAi.. t40ME5, INC.
�Iq�]IfM7.T7Mn11),7{?X{y�hc)I'lMASMRlIfT1.9R/S
F�wkMe�Mlww�la^w�.aw W�kwwl�iwrMeniMmn .
Payment Summary
Effeotive: September 23, 2013
Contrect Total Less Discaunts Addltlonal Addklonal Origlr�al Baisnca
Purehases DiscourKs
$7,517.00 -$144.00 $4A0 -$fl.04 $?,417.00
OaGc Psy Msthod�i»ck No Typa Apwi�d To Received From Mrount
9/23/13 Check#0991 Payment Contract Maxine Botts $7,417.00
Total $7,417.00
Orlgir�i 8aiar�ce Lsss Payment 8 AdJuatmsnts Fte#unds Pi�taNS F�as Amount Dtro
S�,ay�.00 -a�an.00 +so.00 +So.00 ` „
Buyer Informetfon: �"�" '^ " �u� I
Ma�cine A. Botts �
10 Keefer Way -C��n t< �W i�Y�}2x� rt.a�,
Mechanicsburg, PA 17055
"�j 8L?
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lfR4'�+ }
�aswnlMpesu.w iwwa�wlnw..
M�wmvyM110{I BolWrA�,1AA07J
s+a.iieo�«.s�.+. �oe.�n.wmu..k.sw.
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HOOVER-BCIYER
FUNERAL. HQMES� tNG.
IIq�1nM7J7Nan�M3At7 fa:�nMXASMa1�f%S.iMiS
ErmaMe�MinwYa^rtdn W�k�wwlMSVmrtan
Augusti,2013
Maxine A. Botts
10 Keefer Way
Mechaniosburg, PA 17055
We appreciate She hust and confidence you have piace in aur firm during the time af your recent loss. it was our
purpase to give ihpughtlul service, and if in so doing we helped to lighten your burden our aim has been
accompiished.
Our staff stands ready to assist you with any details you might need help to eccomplish.
The foi{owing detaii represents the cantract you made wittr us. If any i#am hetein is not entirely clear#o you ar
exacHy in keeping with yaur understanding,we'll deeply appreciate your cooperation in bringing this matter to our
attenbot�.
This is a friendly reminder of your open account here at aur funeral home.
s�.��.��M�.��
Erra R. Hartman
Contract Number:07222013 Contraot Date: 07/22/2013
Date Amount Pey Mathod/CMSCk No Reoslwd From
$0.00
CoMrect To1N Less Diseouna Addl Purohasas Addl DNcouMa Orlginal Belancs
$7,597.00 $10Q.� $0.00 $4.OQ $7,417.�
origh�ai esranes Leea Paymem 81►dJustrnMts Ratunds Pi�tats Fee�s Amounc D�u
$7,417.00 -$0.00 +50.00 +SO.Oq 5�417.OQ
.p.. �� �� a d������..A . Mi. �u.u�.rFSSnxu�. .....__..
..�� ,_
- . " �{����� ���� PAGElOF2
n�.wy��rrw� a�.auo�..r�i»u Cotrtract ff: ff7222013
°i'"£°°'"�s'°" 10e0itM��""`'"'�'�'"" Statement of Caods and Services
�twrnCOrtr�rnr.�� Decaient: Eva R.HeRmsn
�� Date of Death: 7f21120Y3
HQOVER-BCtYER Personresponsibleforpaymentofservices:
' FklNERAL HOMElS� iPIG. Name: ManineA.Botts
Address: i0 Keefer W2V
qwnM:1�7.MtnNa7n.Mt13Ylrr:n7,N2,IfM>7�7JU.w�s MechanicsburSi,PA t�p55
�'"'"«'°"" ���°'" Phone: SSN:
in thia AQreemunt tlfe wortls you and your refer�Me 8uyet and Ca-6uyx;�my,slpning thia Apta•merct The vrortls vro,ue and au�a€ar to tlfe FunaN Provitler a 5eliar
whoae nema and MWreas eppear above.For poo0 and ve�wbie wnsidaraiion,wl�ich eech psry acknaMetlpas teceivinp,yau eqree to Ouy tha pootls antl senices tlescAbad
bNaw.You authoAze us to prepere anC ure Inr Me botly M tM tleceqpnt named in ihi4 Apreement aM Oo contluIX Ne hrreral and aervicea and incuned Me charyea listed in
eakl epreemeM.We heve the ripht M colleM dia totel emounb tlue untler this Ag�aemenl from any peraon who 6�qna thia agreeirwnt as buyor or Co-buyer.
� Chuges are oNy fpr those items tt�at you selectetl or Uial aro required.If we ara raquketl by taw or by a cemetery or cramatpry b uae any iMms,we will pxplain the mawans
in Wtid�Q beiaw.H}rou aedec�!a funani Htat rrteY��ro embeim"s�p.stwh as Nna'N wph viewin8.you ma7'luve M A.Y fw amb�nirlg.Ycw Co rrot heve to pay far
ambtl ' u dld not a if ou ssiected such as diroct camatinn or unmadiete buriN.it we oha #or ambaimi we w�e iain wh !»low.
SERVECES
��������� Cq$H ApyANCES-CNARGES TO SE INCURRED
Minimum Professional Service Fee 2 Q(�0.00 BY US FOR YOU
Cars end Prspsretlon of Remalns Ceah Advancss
Uae of Fadliti�and Related Steff Char9� Cemetety-Mapie Grove 656.i�
Graveside Service 400.00 Obituary Nptice-Patriof News. 200.00
Transportatlon Certitied Copies-20 dC and 10 Free 80.00
Servlce Vehiole 725.00 Ciergyl Religiaus Facliity 15�.40
Monument inscripfion--2413 storte cutting 8T.00 plher Caah Advant�
T07AL CASH ADVANCES 10&1.00
TOTAL SER4ICES 2.612.00
MERCHANpiSE TAX SUMMARY
Casket-New Horizon 2�0�00 Total Tauable Amount=0.00
Outer Buriai-Con-Q-�ite t245.40 Local Tax 0.000% 0.00
State Taac O.tY005'o 4.00
Fbwers-longs. 3i70.00 TOTAL TAX o.00
TOTAL MERCHANDISE 3.846.00 '
CONTRACT SU�AAMARV
Funerai ffome Charges 7517.Ob
Discaunt 100.00
tess Deposit 0.00
BA�AIVCE DUE 74i7.d0
�_ ��, .; � �,,,.�,�,,,�,, .„,� .�,� .�
� �''�
MESSIAH ��.,� ,y �,.;�, � ��� r, � .�€. ��� ..'. .� �.
� i Fam P&o1
����a �M
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..
1 W MT.AILEN DRIVE,MECHANICSBURG,PA 17055 RESIDENT# UNIT ,,,,,,,,,STMT, DATE
3Q647 2551} _Q8t3112023
_,RESiDE.NT{g}
MAXII�iE BOTTS Mrs.EVA R.HARTMAN
10 KEEFER WAY
MECHANICS$URG,PA 17055 TQTAt AMOUNT DUE $16 24.30
DATE DUE 09/30/2013
$
OATE DESCit#PTIpN RATE ��� CMAR{iE3 CREDITS 6AU4HGE
Bxiance Farward 16,324.30
RESIDENT# CURRENT OVER 30 OVER 60 � OVER 90 OVER 120 TOTAL AMQUNT DUE
30607 O,QO 6,655.20 9,532.34 30,00 lOb.$a $16,324.30
RESIDENT NAME Mrs.EVA R HARTMAN �°""PBOt
WA
P'lease make check payable bo Mesdsh Lifewaye at Mes�h Viltage.
A IY�Hnstnce c�args mry be assessed on accounfis for wYich payment has no#beea reeeival by the due date. Thank yau!
If yau Aave any quesNona or concerna sbouk your bill,plesse address tbem directly to Fiscsl 3ervices at 790-8Z20. Thank You!
ETZWEILER AND ASSOCIATES
ATTORNEYS-AT-LAW
105 NORTH FRONT STREET
HARRISBURG, PA 17101-1436
Office hours:Mon.-Fri 8:00 mm.-5:00 p.m.
(717)234-5600
Earl Richard E�weiler,Esqu'ue ___
Chrisdan S.Daghir,Esquire HP.LIFA7{LINE
(717)896-3737
225 Market SVcet Fax Line:(717)2345610 2 West Main Street
Millersburg,PA 17061 Email Address: retzweiler(alcomcastnet Elizebethville,pA 17023
('7]'n 692-2519 (717)362-8395
O,fJ7ce kours: Tues. and FrL 4:00 p.m.-8:00 p.m. OJJtce kours: Thurs. 7:00 p.m.-9:00 p.m.
Sat 10:00 am.-12:00 noon
October 23, 2013
Register of Wills c� �; � ,�
Cumberland County Courthouse � o -_> �>> �
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RE: Estate of Eva R. Hartman . =-� �-' " r��
D.O.D. 7/21/13 i' �� o �' -�'.,
No. 21-13-0842
Gentlemen:
Please find enclosed three fully-executed copies of the Inheritance Tax Retum and
Inventory for the above-referenced estate. Please time-stamp the extra copies and retum
them to my office in the enclosed self-addressed postage prepaid envelope.
Please contact my office if you need anything further in this matter.
Sincerely yours,
���
Earl Richard Etzweiler
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